MRI brain scans can reliably detect the early signs of multiple sclerosis and predict how severe the condition will be, scientists say.

The conclusion is based on research carried out by the Institute of Neurology in London spanning more than 18 years.

Until recently, an official diagnosis of multiple sclerosis was not made until patients had two episodes of nerve problems in different parts of the body.

This may help to increase the speed of diagnosis for many people with
MS

Nicola Russell

These flare ups could be separated by a period of years, during which time damage was accumulating in the body.

The new work could lead to earlier interventions to minimise this damage.

Recent research has found that putting patients on multiple sclerosis drugs at the first sign of nerve inflammation can sharply cut the chances of developing the disorder within a few years.

MRI scans work by using magnetic fields and radio waves to capture cross-sectional images of the brain. This enables doctors to identify damage around nerve fibres associated with multiple sclerosis.

Tests on 71 volunteers who were suspected of having multiple sclerosis as early as 1984 found that 88% of the 50 people with an abnormal MRI went on
to develop the condition.

Of the remaining 21 whose MRI scans appeared normal, only 19% went on to develop the condition.

Defects

The researchers, led by Dr Peter Brex, said that their work showed that using an MRI scan to measure the size of defects in the brain was helpful in assessing the risk of future disability.

However, they warned that the size of the defects did not always correlate with the severity of future disability.

Multiple sclerosis, which affects about one in 1,000, progressively destroys the electrical insulation surrounding nerve cells.

It has been very difficult to study because symptoms come and go in an unpredictable way.

But knowing that nearly nine out of 10 people with an
abnormal MRI scan are destined to develop the illness may help scientists develop better treatments that can be applied before too much damage has been done to the brain and the rest of the nervous system.

Nicola Russell, of the MS Trust, said: "This study proves that MRI scans can accurately detect areas of damage within the brain and spine and this, together with other diagnostic procedures, may help to increase the speed of diagnosis for many people with
MS.

"This will allow them to receive drugs at an earlier stage which will potentially increase their efficacy and could have far-reaching implications in terms of improving their quality of life."

Body keeps fighting

In a separate study doctors at The Cleveland Clinic Foundation said they had discovered the body never seems to give up as it tries to repair the damage
caused by MS.

Autopsies on 10 people found their brains continued to make cells that try to repair the insulation destroyed by the disease.

Researcher Dr Bruce Trapp said the findings offer hope scientists might discover a way to help the existing cells make insulation faster than MS can destroy it.

The research also suggests that if an effective
treatment is found, it might work for people who have suffered with MS for many years.

He said: "We have assumed that the brain did not repair the lesions during more chronic stages of multiple sclerosis because we believed the new cells were not being generated.

"We may be able to manipulate the cells produced by the brain so the cells complete the repair process."